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Questions about registration? Click Here!

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Conference 2012

Breastfeeding - Keep it Simple!

Speaker: Dr. Christina Smillie

 

Victoria, B.C., Feb 4, 2012

To pay by cheque, please use the form below to provide your information. !NEW! Our $180 price has been extended to Jan 31! Can you find two other people who also want to come to the conference? You qualify for the group rate! Provide the names of the other members of your group in the appropriate place on the form, and put $160 as your Payment amount. Late registration (after Jan 31) is $195. Make your cheque payable to Breastfeeding Matters - SVI and mail to:

Breastfeeding Matters - SVI
1616 Burton Ave
Victoria BC
V8T 2N6

 

This form will generate an email message when you hit Submit. When it does, click send in your email software - no further changes will be needed.

First name:
Last name:
Title:
Email address:
Registration type:
Payment amount ($180, or $160 if part of a group):
Address:
City:
Postal/Zip Code:
Organization/Company:
Position:
Name tag as you would like it:
Dietary considerations:
If applicable, who are the other people in your group?